PatientBiologicalSex

Reference data entity for administrative sex used in clinical and medical contexts. Distinct from gender identity, which is captured separately in Patient via the gender field.

Overview

PatientBiologicalSex captures the biological/anatomical sex recorded for clinical decision-making purposes. This information is essential for sex-specific medical screening, medication dosing, laboratory reference ranges, and clinical risk assessments. The entity follows healthcare standards that distinguish between biological sex (relevant for clinical care) and gender identity (relevant for patient communication and respect).

Key Concepts

Biological Sex vs Gender Identity

Healthcare systems track both concepts separately:

Concept	Field	Purpose
Biological Sex	`biologicalSex`	Clinical decisions, lab ranges, screenings
Gender Identity	`gender`	Patient communication, respectful care

A patient may have biologicalSex: female and gender: male (transgender man), requiring both pieces of information for comprehensive care.

Clinical Applications

Biological sex affects numerous clinical decisions:

Medication Dosing

Drug metabolism differences between sexes
Pregnancy risk considerations
Hormone-related medication adjustments

Laboratory Interpretation

Different reference ranges for hemoglobin, creatinine
Sex-specific hormone panels
Cardiac enzyme thresholds

Screening Recommendations

Mammography, cervical cancer screening
Prostate cancer screening
Bone density testing thresholds

Risk Assessment

Cardiovascular risk calculators
Osteoporosis risk scores
Cancer risk models

Standard Values

Code	Label	Clinical Context
`male`	Male	XY chromosomes typical; male anatomy
`female`	Female	XX chromosomes typical; female anatomy
`intersex`	Intersex	Variations in sex characteristics
`unknown`	Unknown	Unable to determine or not recorded

Intersex Considerations

The intersex value accommodates individuals with:

Chromosomal variations (XXY, XO, etc.)
Differences in sex development (DSD)
Ambiguous anatomical characteristics

Clinical systems should allow additional documentation of specific conditions when intersex is selected.

Use Cases

Patient Registration

During intake:

Record biological sex from identity documents or patient report
Separately record gender identity for communication preferences
Flag any discrepancy for appropriate clinical handling
Ensure both fields are captured for complete record

Clinical Decision Support

When applying sex-based rules:

Retrieve patient's biologicalSex value
Apply appropriate reference ranges or screening rules
Consider additional context (transgender status, hormone therapy)
Document any clinical overrides with reasoning

Laboratory Ordering

When processing lab orders:

Check biologicalSex for reference range selection
Apply sex-specific normal ranges to results
Flag abnormals based on appropriate thresholds
Allow manual override when clinically indicated

Preventive Care Reminders

For screening recommendations:

Query patients by biologicalSex and age
Generate appropriate screening reminders
Consider individual circumstances (hysterectomy, orchiectomy)
Document declined or inapplicable screenings

Related Entities

Entity	Relationship	Description
Patient	Referenced by	Patient records that use this biological sex value
Gender	Complements	Gender identity (separate concept from biological sex)

Enums

code

Value	Description
`male`	Biological male - typically XY chromosomes and male reproductive anatomy
`female`	Biological female - typically XX chromosomes and female reproductive anatomy
`intersex`	Intersex - individuals with variations in sex characteristics not fitting typical male/female definitions
`unknown`	Unknown - biological sex has not been determined or recorded

2 properties

Schema

Properties

Property	Type	Mode	Description	Required
code	string	stored	Standardized code for biological sex Values: `male, female, intersex, unknown` Example: `"male"`	Required
label	string	stored	Human-readable display label Example: `"Male"`	Required

Examples

Example 1

{
  "@type": "PatientBiologicalSex",
  "code": "male",
  "label": "Male"
}

Example 2

{
  "@type": "PatientBiologicalSex",
  "code": "female",
  "label": "Female"
}

Example 3

{
  "@type": "PatientBiologicalSex",
  "code": "intersex",
  "label": "Intersex"
}

Example 4

{
  "@type": "PatientBiologicalSex",
  "code": "unknown",
  "label": "Unknown"
}